In a 99 percent:1 percent world, it makes perfect sense to save government health care by going after doctors.

The result of reducing reimbursement rates for occupational therapists, the subject of hearings this week in Austin, will be to further discourage doctors from practicing in the poorest parts of Texas, according to a story posted Sunday in the Fort Worth Star-Telegram.

Overworked doctors in rural south Texas are at the center of a shift to managed care, which the state hopes will save taxpayers as much as $300 million.

The cost of Medicaid, $24.7 billion this year, represents about a third of the state budget serving 3.4 million children, elderly, blind and disabled Texans, the paper says. Roughly two-thirds of Medicaid in Texas is paid for with federal taxpayer funds and the other third from state taxpayers. The program has grown to the point where one in six Texans were benefiting from the entitlement in 2009.

The Texas Health and Human Services Commission, which is conducting the hearings, plans to cut payments to therapists by $150 million a year. The cuts are to be made by bringing reimbursement rates for the Medicaid programs in line with similar services paid for through Medicare.

The state is also trying to save millions more by dropping co-payments to doctors for people eligible for Medicare and Medicaid.

"It's another small step in the direction of making it harder to practice medicine in Texas," Dee Dockery, a radiologist and spokesman for the Texas Radiological Society, told the Star-Telegram.

The Social Security Administration recently attempted to make it easier to practice medicine for doctors reviewing federal disability applications by cutting their hourly review rate and ordering them to work faster, according to a sobering story today by the Wall Street Journal.

Although it did nothing for the backlog of disability claims, it did wonders for reducing payroll. Forty-five doctors either quit or were fired. Administrators have tried to make up for the shortage by having doctors review claims outside of their area of medical expertise.

The result, the critics say, will be an increase in awards to people who don’t qualify and denials to those who do.